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Hollywood Dermatology and Cosmetic Surgery Specialists, PLLC fax number
(954) 963-0378
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Dermatology and Cosmetic Surgery
Used for: Medical records release/authorization, including releasing records (Authorization for Release of Medical Records)
Fax destination details
- Department
- Dermatology and Cosmetic Surgery
- Purpose
- Medical records release/authorization, including releasing records (Authorization for Release of Medical Records)
- Form
- Authorization for Release of Medical Records — Authorization for Release of Medical Records
- Address
- 3850 Hollywood Blvd, Ste 301, Hollywood, FL 33021-6745, United States
- Voice phone
- 954-961-1200
- Website
- Visit organization website
Before you send
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Complete patient name, date of birth, and recipient information; specify records to be released, dates of service, and sign/date. The form instructs that records should be faxed to the provided recipient and includes multiple Hollywood office locations.
Official form instructions are published as a downloadable file on the organization's website.
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